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Risk of stroke or myocardial infarction hospitalisation following hospitalisation for community-acquired pneumonia in Portugal: a self-controlled case series study

2025-11-09Artigo científico Acesso aberto
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datacite.subject.fosCiências Médicas::Ciências da Saúde
datacite.subject.sdg03:Saúde de Qualidade
dc.contributor.authorCarneiro, Joana
dc.contributor.authorLeite, Andreia
dc.contributor.authorLahuerta, Maria
dc.contributor.authorCatusse, Julie
dc.contributor.authorAli, Mohammad
dc.contributor.authorTeixeira, Rita
dc.contributor.authorLopes, Sílvia
dc.date.accessioned2026-01-13T12:09:32Z
dc.date.available2026-01-13T12:09:32Z
dc.date.issued2025-11-09
dc.description.abstractObjectives: We aimed to assess the risk of cardiovascular hospitalisations (stroke or myocardial infarction (MI)) following a community-acquired pneumonia (CAP) hospitalisation in a large Portuguese administrative dataset. Design: Self-controlled case series study. Setting: We used hospitalisation data from National Health Service hospitals across Portugal between 2010 and 2018. Participants: Adults hospitalised for both CAP and stroke/MI in Portugal during the 2010-2018 period (n=13 494, of which 10 400 with stroke and 3094 with MI). Primary and secondary outcome measures: We considered CAP hospitalisation as the exposure (14-, 28- and 91-day exposure periods) and acute cardiovascular (stroke or MI) hospitalisations as the outcome. Incidence rate ratios (IRR) were computed using a conditional Poisson regression (overall and by sex and age subgroups). Results: Patients were mostly male and above 75 years. Stroke/MI hospitalisation incidence was higher following CAP, compared with the baseline period. Largest differences were observed in the 14-day period after discharge (IRR for stroke: 2.55, 95% CI: 2.33-2.80; IRR for MI: 3.23, 2.78-3.75), compared with the 28-day (IRR for stroke: 2.06, 1.92-2.22; IRR for MI: 2.62, 2.32-2.95) and 91-day periods (IRR for stroke: 1.37, 1.30-1.44; IRR for MI: 1.75, 1.60-1.91). A similar trend was observed for sex and age subgroups. Conclusions: Our study shows an increased risk of stroke/MI for CAP patients, particularly during the first 2 weeks after being discharged. Effective postdischarge monitoring and follow-up, combined with efforts to prevent CAP occurrence, could improve patient outcomes.eng
dc.description.abstractStrengths and limitations of this study: - Our study used the self-controlled case series method, where each participant serves as their own control, consequently adjusting for fixed individual covariates; - We studied a large sample using hospitalisation data from a national-level database over an 8-year period; - Some cardiovascular events may not have been captured by our study (eg, only the first episode after the CAP hospitalisation was included).eng
dc.description.sponsorshipThis study was conducted as a research collaboration between the NOVA National School of Public Health (sponsor) and Pfizer, Inc. (funder).
dc.identifier.citationBMJ Open. 2025 Nov 9;15(11):e101068. doi: 10.1136/bmjopen-2025-101068
dc.identifier.doi10.1136/ bmjopen-2025-101068
dc.identifier.eissn2044-6055
dc.identifier.pmid41213677
dc.identifier.urihttp://hdl.handle.net/10400.18/10683
dc.language.isoeng
dc.peerreviewedyes
dc.publisherBMJ Publishing Group
dc.relation.hasversionhttps://bmjopen.bmj.com/content/15/11/e101068
dc.relation.ispartofseriese101068
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/
dc.subjectPneumonia
dc.subjectSelf-Controlled Case Series
dc.subjectRisk Factors
dc.subjectRespiratory Infections
dc.subjectCuidados de saúde
dc.subjectEstados de Saúde e de Doença
dc.subjectInfecções Respiratórias
dc.subjectPortugal
dc.titleRisk of stroke or myocardial infarction hospitalisation following hospitalisation for community-acquired pneumonia in Portugal: a self-controlled case series studyeng
dc.typejournal article
dcterms.referenceshttps://bmjopen.bmj.com/content/bmjopen/15/11/e101068/DC1/embed/inline-supplementary-material-1.pdf?download=true
dspace.entity.typePublication
oaire.citation.issue11
oaire.citation.startPagee101068
oaire.citation.titleBMJ Open
oaire.citation.volume15
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85
person.familyNameLeite
person.givenNameAndreia
person.identifier1052436
person.identifier.ciencia-id2F10-F9A9-E8A7
person.identifier.orcid0000-0003-0843-0630
person.identifier.scopus-author-id57109931300
relation.isAuthorOfPublication838ff85b-16c9-4992-b13f-e3099f916717
relation.isAuthorOfPublication.latestForDiscovery838ff85b-16c9-4992-b13f-e3099f916717

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